Department of Orthopedic Surgery, University of Pittsburgh Medical Center - Hamot, Erie, PA, USA.
Upper Extremity Center of Excellence, Shriners Hospital for Children, Philadelphia, PA, USA.
J Hand Ther. 2018 Jul-Sep;31(3):357-370. doi: 10.1016/j.jht.2017.03.001. Epub 2017 Apr 25.
Cross-sectional clinical measurement study.
Scapular winging is a frequent complaint among children with brachial plexus birth palsy (BPBP). Therapeutic taping for scapular stabilization has been reported to decrease scapular winging.
This study aimed to determine which therapeutic taping construct was most effective for children with BPBP.
Twenty-eight children with BPBP participated in motion capture assessment with 4 taping conditions: (1) no tape, (2) facilitation of rhomboid major and rhomboid minor, (3) facilitation of middle and lower trapezius, and (4) facilitation of rhomboid major, rhomboid minor, and middle and lower trapezius (combination of both 2 and 3, referred to as combined taping). The participants held their arms in 4 positions: (1) neutral with arms by their sides, (2) hand to mouth, (3) hand to belly, and (4) maximum crossbody adduction (CBA). The scapulothoracic, glenohumeral and humerothoracic (HT) joint angles and joint angular displacements were compared using multivariate analyses of variance with Bonferroni corrections.
Scapular winging was significantly decreased in both the trapezius and combined taping conditions in all positions compared with no tape. Rhomboids taping had no effect. Combined taping reduced HT CBA in the CBA position.
Rhomboid taping cannot be recommended for treatment of children with BPBP. Both trapezius and combined taping approaches reduced scapular winging, but HT CBA was limited with combined taping. Therefore, therapeutic taping of middle and lower trapezius was the most effective configuration for scapular stabilization in children with BPBP. Resting posture improved, but performance of the positions was not significantly improved.
Level II.
横断面临床测量研究。
肩胛骨翼状突出是臂丛神经麻痹(BPBP)患儿常见的主诉。有报道称,肩胛稳定治疗贴扎可减少肩胛骨翼状突出。
本研究旨在确定哪种治疗贴扎结构对 BPBP 患儿最有效。
28 名 BPBP 患儿参与运动捕捉评估,有 4 种贴扎条件:(1)无贴扎,(2)辅助菱形肌和小菱形肌,(3)辅助中、下斜方肌,(4)辅助菱形肌、小菱形肌和中、下斜方肌(第 2 和第 3 种的组合,称为联合贴扎)。参与者将手臂置于 4 个位置:(1)中立位,手臂放在身体两侧,(2)手到口,(3)手到腹部,(4)最大交叉体侧内收(CBA)。使用多元方差分析和 Bonferroni 校正比较肩胛胸、盂肱和胸锁关节角度和关节角位移。
与无贴扎相比,斜方肌和联合贴扎条件下所有位置的肩胛骨翼状突出均显著减少。菱形肌贴扎无效果。联合贴扎在 CBA 位置减少了 HT CBA。
不建议对 BPBP 患儿进行菱形肌贴扎治疗。斜方肌和联合贴扎方法均能减少肩胛骨翼状突出,但联合贴扎会限制 HT CBA。因此,治疗性贴扎中下斜方肌是 BPBP 患儿肩胛稳定的最有效方法。休息姿势有所改善,但位置的表现没有显著改善。
II 级。